Journal of Foot & Ankle Surgery最新文献

{"title":"Is the posterior malleolus reliably reduced by fibula fixation alone? A prospective CT-based study.","authors":"Meletis Rozis, Lyndon Mason, Dimitrios-Stergios Evangelopoulos, Eleftherios Stavridis, Spyros Pneumaticos","doi":"10.1053/j.jfas.2025.06.016","DOIUrl":"10.1053/j.jfas.2025.06.016","url":null,"abstract":"<p><strong>Background: </strong>Posterior malleolus fractures have the potential to be automatically reduced after fibula fixation, thus not requiring fixation. Nevertheless, there are no data in the literature supporting this theory. We have performed a prospective CT study to evaluate the quality of indirect posterior malleolus fragment reduction via ligamentotaxis in ankle fractures.</p><p><strong>Purpose: </strong>To examine the role of ligamentotaxis in posterior malleolus reduction.</p><p><strong>Study design: </strong>Prospective, Computed Tomography study.</p><p><strong>Methods: </strong>We included seventy-one patients with ankle fractures who did not undergo direct fixation of the posterior malleolus. Postoperative CT scans compared the injured and normal ankles, assessing reduction quality based on fragment translation.</p><p><strong>Results: </strong>The fractures were classified as Mason type 1, 2A, 2B, and 3. The results showed that indirect reduction was anatomical in 91.3 % of Mason type 1 fractures, 54.5 % of Mason type 2A fractures, 31.25 % of Mason type 2B fractures, and 76.2 % of Mason type 3 fractures. Mason type 2 fractures exhibited the most variability in reduction quality. The incisura anatomy was additionally affected, with a significant decrease in the normal notch retroversion.</p><p><strong>Conclusion: </strong>Indirect reduction of the posterior malleolus via ligamentotaxis yields unpredictable results related to the fragment morphology, making preoperative CT evaluation highly suggested for ankle fracture treatment. Our study indicates that the posterior malleolus cannot be always reduced through fibula fixation in patients with Mason 2 and Mason 3 fracture types, with those fractures requiring direct fixation. Further research is needed to evaluate the clinical importance of malreduced posterior malleolar fragments on ankle joint function.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term clinical outcomes of cross-linked hyaluronic acid filler injection in the treatment of plantar fat-pad atrophy syndrome.","authors":"Seung Hyo Ko, Bomsoo Kim","doi":"10.1053/j.jfas.2025.07.004","DOIUrl":"10.1053/j.jfas.2025.07.004","url":null,"abstract":"<p><strong>Background: </strong>Plantar fat-pad atrophy syndrome is characterized by thinning of the heel and forefoot fat pads, causing pain and functional limitation. Conventional treatments, such as heel cups and taping, offer only temporary relief and are often hindered by poor patient compliance.</p><p><strong>Purpose: </strong>To evaluate the short-term clinical outcomes and complications of cross-linked hyaluronic acid (HA) filler injections into the plantar region of the foot.</p><p><strong>Study design: </strong>Prospective case series.</p><p><strong>Methods: </strong>Twenty-eight patients (30 feet) with plantar fat-pad atrophy received injections of cross-linked HA filler (YVOIRE® Contour Plus C, LG Chem, Ltd., Seoul, Korea). The primary outcome was change in Visual Analogue Scale (VAS) at 24 weeks. Secondary outcomes included EQ-5D-3 L, Foot and Ankle Outcome Score (FAOS), Foot Function Index (FFI), fat pad thickness, and patient satisfaction. Adverse events were recorded.</p><p><strong>Results: </strong>VAS improved from 6.86 ± 1.67 to 3.50 ± 2.67 at 24 weeks (p < .001). EQ Index, FAOS, and FFI scores also improved significantly (all p < .05). Repeated measures ANOVA showed significant time effects across all clinical outcomes (p < .05). Fat pad thickness increased by 1.45 ± 1.59 mm at the heel and 2.67 ± 0.63 mm at the forefoot. Six patients experienced adverse events (pain, inflammation, and migration), all resolved conservatively.</p><p><strong>Conclusion: </strong>Cross-linked HA filler injections provide short-term pain relief and functional improvement in plantar fat-pad atrophy. Future work should focus on optimizing filler materials, injection techniques, and rehabilitation protocols.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical versus nonoperative treatment for severe acute lateral ankle ligament injuries: A long-term follow-up study.","authors":"Hideo Noguchi, Yoshinori Ishii, Junko Sato, Ikuko Takahashi","doi":"10.1053/j.jfas.2025.05.011","DOIUrl":"10.1053/j.jfas.2025.05.011","url":null,"abstract":"<p><p>This study evaluates outcomes and long-term reinjury rates in patients with severe lateral ankle ligament injuries treated surgically versus nonoperatively. A combined surgical and arthroscopic approach was used for such cases. From 2004 to 2013, 103 patients with acute lateral ankle ligament injuries and a talar tilt angle (TTA) of ≥ 15° underwent surgical treatment. At 3 months postoperatively, TTA reassessment in 85 feet (82.5 %) showed a mean improvement from 23.9° to 5.8°. The mean AOFAS score reached 97.1 points at 3 months, reflecting excellent patient outcomes. In contrast, 132 patients received nonoperative treatment. Although TTA improved from 19.3° to 8.5° with nonoperative treatment, the follow-up rate was lower (28.2 %) than among those undergoing surgery. Sixty patients returned to the clinic until 2024 for follow-up due to re-sprains. Among the 103 patients in the surgical treatment group, 18 experienced re-sprains. Although no additional surgery was required, 4 patients developed chronic lateral ankle ligament instability. Of the 132 patients in the nonoperative treatment group, 42 experienced re-sprains; 6 patients progressed to chronic instability. Despite the high success rate of nonoperative treatment for lateral ankle ligament injuries, surgery is recommended for patients with a TTA of ≥ 15°. Approximately 90 % of patients may achieve favorable outcomes with conservative management, while a subset may progress to chronic ankle instability. Although surgery involves potential drawbacks, the benefits often outweigh the risks, particularly in patients with severe ligament damage.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramedullary tension band technique versus distal ulnar hook plate in treating the fifth metatarsal base fractures.","authors":"Jingquan Guo, Qianwen Jia, Fei Xiao, Keke Cheng, Tianrun Lei, Bo Wu","doi":"10.1053/j.jfas.2025.07.001","DOIUrl":"10.1053/j.jfas.2025.07.001","url":null,"abstract":"<p><strong>Background: </strong>Displaced or comminuted fifth metatarsal base fractures remain challenging, with no consensus on optimal surgical treatment.</p><p><strong>Purpose: </strong>To compare clinical outcomes between intramedullary tension-band and distal ulna hook plate fixation for treating Zone 1 (tuberosity avulsion) fractures of the fifth.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>This study included 43 patients with Zone 1 fractures treated surgically between August 2019 and August 2023. Patients were divided into two groups: 22 treated with intramedullary tension-band and 21 treated with hook plate fixation. Clinical and radiographic outcomes were assessed, including operative time, incision length, reduction quality, fracture healing time, AOFAS scores at 3, 6, and 12 months, and postoperative complications.</p><p><strong>Results: </strong>The tension-band group showed significantly shorter operative time (28.4 ± 3.2 vs. 48.9 ± 8.6 min, P < 0.01) and smaller incisions (3.5 ± 0.3 vs. 6.1 ± 0.6 cm, P < 0.01), with no cases of implant irritation or nerve symptoms. The hook plate group achieved better immediate reduction (0.2 ± 0.2 vs. 0.7 ± 0.3 mm, P = 0.01), faster union (6 vs. 8 weeks, P < 0.01), and higher AOFAS scores at 3 months (P < 0.01). However, functional outcomes were similar at 6 and 12 months. Both groups achieved complete fracture union.</p><p><strong>Conclusion: </strong>Both techniques are effective for Zone 1 fifth metatarsal base fractures. Tension-band fixation offers a less invasive alternative with reduced morbidity and need for implant removal, while the hook plate provides faster early recovery.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive osteotomies of the second and third metatarsals for the management of metatarsalgia in hallux valgus with plantar plate rupture.","authors":"Barbara Piclet-Legré, Lucile Vais, Stéphanie Cohen, Lolita Micicoi","doi":"10.1053/j.jfas.2025.06.015","DOIUrl":"10.1053/j.jfas.2025.06.015","url":null,"abstract":"<p><strong>Background: </strong>Distal Minimally invasive metatarsal osteotomies (DMMOs) shorten the metatarsals While allowing automatic adjustment of the metatarsal heads in all three planes through immediate weight-bearing. In hallux valgus (HV) surgery, transfer metatarsalgia can be managed with percutaneous DMMOs.</p><p><strong>Purpose: </strong>This study is a retrospective study that evaluates the clinical and radiological outcomes of DMMOs limited to the second and third metatarsals for metatarsalgia with plantar plate injury associated with HV.</p><p><strong>Study design: </strong>A single-center study of 102 patients who underwent surgery between 2011 and 2020.</p><p><strong>Methods: </strong>Demographic, radiological, clinical (AOFAS score), and complication data were analyzed. Minimally invasive DMMOs of the second and third metatarsals were performed under fluoroscopic guidance, followed by a chevron osteotomy of M1 to realign forefoot length.</p><p><strong>Results: </strong>We observed significant metatarsal shortening and AOFAS a signifiant improvement (p < 0.05) with a postoperative value of 92.25 ± 3.7 (range: 71.2-98.2). No recurrences, three cases of transfer metatarsalgia, and six delayed unions were reported DMMOs of the second and third metatarsals appear to be a reliable option for treating metatarsalgia with plantar plate injury in HV.</p><p><strong>Conclusion: </strong>DMMOs of the second and third metatarsals appear to be a reliable option for treating metatarsalgia with plantar plate injury in association with surgical correction of HV. We observed no recurrence of metatarsalgia, and the risk of transfer metatarsalgia was less than 2.9.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MICA for all hallux valgus severity grades: A retrospective outcome study.","authors":"Michael Michlin, Mor Bracha Akselrad, Ophir Freund, Yaron Brin, Ezequiel Palmanovich, Nissim Ohana","doi":"10.1053/j.jfas.2025.06.014","DOIUrl":"10.1053/j.jfas.2025.06.014","url":null,"abstract":"<p><strong>Background: </strong>Surgical treatment for hallux valgus (HV) has traditionally been guided by deformity severity. Severe HV was typically addressed with proximal corrections, while mild to moderate cases received distal osteotomies. Recent studies suggest that even severe HV can be effectively managed using minimally invasive distal techniques.</p><p><strong>Purpose: </strong>To evaluate outcomes of the Minimally Invasive Chevron and Akin (MICA) procedure across HV severity grades and assess the relevance of traditional severity-based classification in surgical decision-making.</p><p><strong>Study design: </strong>Retrospective clinical measurement study with radiographic and patient-reported outcomes analysis.</p><p><strong>Methods: </strong>A single-center retrospective study included 120 feet (111 patients) treated with MICA for isolated HV between 2016 and 2022. Radiographic and Patient-Reported Outcome Measures (PROMs) were assessed with a minimum two-year follow-up. Deformities were classified as severe or non-severe (mild-moderate) based on standard angular thresholds.</p><p><strong>Results: </strong>Thirty-two cases (26.7 %) were classified as severe and 88 (73.3 %) as non-severe. Median (IQR) pre-operative and post-operative first intermetatarsal angles (IMA1) were 14.0 (11-16) and 2.6 (1.3-4.8) degrees, respectively. Median pre-operative and post-operative hallux valgus angles (HVA) were 31.2 (26-38) and 8.8 (4.2-11.6) degrees. Median EFAS scores were 19 for severe and 22 for non-severe groups (p = .228). Satisfaction rates were comparable with 84 % in the severe group and 83 % in the non-severe group. PROMs were not associated with preoperative HV severity (p > .1).</p><p><strong>Conclusion: </strong>MICA is effective across all HV severity grades, challenging the need for traditional severity-based classification in surgical planning.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of revision and other complications in total ankle arthroplasty do not differ by surgeon specialty: Analysis of the PearlDiver healthcare claims database from 2010 to 2023.","authors":"Adam E Fleischer, Rachel H Albright, Khushiben Patel, Hector Santiago, Jonathan Hook, Dyane Tower, Lowell Weil","doi":"10.1053/j.jfas.2025.07.003","DOIUrl":"10.1053/j.jfas.2025.07.003","url":null,"abstract":"<p><strong>Background: </strong>Total ankle arthroplasty (TAA) utilization has significantly increased in the US in recent years, and current studies examining surgeon specialty and TAA outcomes are limited.</p><p><strong>Purpose: </strong>To explore the effect of surgeon specialty on long-term TAA survivorship and short-term postoperative complications STUDY DESIGN: Retrospective cohort study and time-to-event analysis METHODS: Using a large, national claims database (PearlDiver, Inc.) with more than 170 million patient files we examined the association of surgeon specialty (podiatric surgeon vs. other) on adverse patient outcomes from January 2010 to April 2023. Relevant covariates were adjusted for using multivariable Cox and logistic regression models.</p><p><strong>Results: </strong>There were 16,485 people who underwent TAA for a cumulative rate of 9.7 per 100,000. Surgeon specialty was known for 13,514 TAA surgeries. There were 714 revisions corresponding to a revision rate of 0.053 (714/13,514) over the 13-year study period. Patients who underwent TAA by podiatric surgeons were no more likely to experience revision surgery than those undergoing TAA by other surgeon specialties (adjusted hazards ratio [HR] 0.84, 95 % CI 0.46 to 1.53, p = 0.57). Furthermore, the risk of readmission (adjusted odds ratio [OR] 1.0, 95 % CI 0.77 to 1.30), infection (adjusted OR 0.91, 95 % CI 0.77 to 1.07), and venous thromboembolism (adjusted OR 0.83, 95 % CI 0.61 to 1.09) within the first 90 days postoperatively did not differ among surgeon specialty.</p><p><strong>Conclusion: </strong>This information may be of interest to third party payers, health administrators, and healthcare consumers.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of dexamethasone iontophoresis as treatment for insertional Achilles tendonitis.","authors":"Devon Niewohner, Justin Waller, Alec Wroblewski, Hayden Bush, Luke Leffler, Lyle Paukner, Dekarlos Dial","doi":"10.1053/j.jfas.2025.06.005","DOIUrl":"10.1053/j.jfas.2025.06.005","url":null,"abstract":"<p><strong>Background: </strong>Dexamethasone iontophoresis has been used to treat insertional Achilles tendonitis with varying effects.</p><p><strong>Purpose: </strong>This retrospective study evaluated the effectiveness of dexamethasone iontophoresis (DI) in patients with insertional Achilles tendinopathy (IAT) or retrocalcaneal bursitis.</p><p><strong>Study design and method: </strong>We analyzed 159 patients, of which 87 received three or more DI treatments. We compared first and last-visit pain scores, range of motion (ROM), and posterior heel spur size radiographic measurements.</p><p><strong>Results: </strong>No significant differences between treatment groups were observed in pain or ROM (p-values >0.3). However, a substantial difference in posterior heel spur size was found, with more prominent spurs associated with more than three treatments (p-value = 0.019). Although not statistically significant, it was noted that increased spur size and Haglund bump height were linked to a higher likelihood of surgical intervention.</p><p><strong>Conclusion: </strong>This study suggests DI may provide short-term relief in IAT but does not significantly improve long-term functional outcomes. Radiographic analysis can guide treatment, particularly in more prominent posterior heel spurs. Further prospective research is needed to explore the long-term efficacy of DI in managing IAT.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative complications in patients with diabetes undergoing total ankle replacement: A 30-, 90-, and 365-day analysis.","authors":"Shiv J Patel, Adam Nguyen, Samuel S Gay, Mohammed S Abdullah, Vinod K Panchbhavi","doi":"10.1053/j.jfas.2025.06.013","DOIUrl":"10.1053/j.jfas.2025.06.013","url":null,"abstract":"<p><p>Diabetes mellitus is a well-known risk factor for postoperative complications. This study compared the rates of postoperative complications at 30, 90, and 365 days in patients with diabetes mellitus and without diabetes mellitus undergoing total ankle replacement. A retrospective cohort study of patients who underwent total ankle replacement from 2008-2023 was conducted using the TriNetX database. The outcomes of infection, periprosthetic fracture, deep vein thrombosis, wound dehiscence, and pulmonary embolism were analyzed. Data was assessed at 30, 90, and 365 days postoperatively using chi-square analysis, followed by calculation of odds ratios. A total of 5,848 patients were identified and 960 patients each remained in the diabetes mellitus and non-diabetes mellitus groups after propensity matching. Patients with diabetes mellitus undergoing total ankle replacement had higher rates of infection and wound dehiscence at 90 and 365 days postoperatively. At 90 days, both infection and wound dehiscence were significantly increased. Similarly, at 365 days, the odds of infection and wound dehiscence remained significantly elevated compared to non-diabetic controls. No significant differences were observed in periprosthetic fracture, deep vein thrombosis, pulmonary embolism at any postoperative internal.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of the interosseus talocalcaneal ligament in progressive collapsing foot deformity: A review of the literature and description of a novel surgical technique.","authors":"Francois Lintz, Enrico Pozzessere, Carla Carfì, Kanyakorn Riewruja, Wolfram Grün, Canon Cornelius, Scott J Ellis, Cesar de Cesar Netto","doi":"10.1053/j.jfas.2025.06.008","DOIUrl":"10.1053/j.jfas.2025.06.008","url":null,"abstract":"<p><strong>Background: </strong>The Interosseous Talo-Calcaneal Ligament (ITCL) is a key stabilizer of the subtalar joint, essential in preventing talo-calcaneal divergence. Its attenuation significantly contributes to the pathogenesis of Progressive Collapsing Foot Deformity (PCFD). Thus, anatomical reconstruction of the ITCL could offer promise in treating flexible (Stage 1) PCFD, aiming to restore subtalar joint stability and prevent deformity progression. The aim of the present work was to report existing ITCL reconstruction techniques and present a novel approach in PCFD.</p><p><strong>Study design: </strong>Current concept and technical note METHODS: A focused current concepts review of existing literature on ITCL reconstruction was performed to identify opportunities and existing gaps. Subsequently, we introduced a novel surgical technique for anatomically reconstructing the ITCL, spring ligament, and superficial deltoid ligament complex using a semitendinosus allograft. Dedicated targeting guides were employed to ensure precise identification and accurate placement of ligament attachment sites.</p><p><strong>Results: </strong>Current literature primarily discusses ITCL reconstruction within the context of subtalar instability associated with Chronic Lateral Ankle Instability (CLAI). However, no prior method has explicitly addressed ITCL reconstruction for managing PCFD, which constitutes a significant gap in the literature. We describe a novel surgical technique to address ITCL reconstruction in flexible (Stage 1) PCFD.</p><p><strong>Conclusion: </strong>ITCL reconstruction the logical next step in conservative treatment of flexible PCFD with peritalar subluxation (class D), to circumvent the need for joint-sacrificing procedures. A novel surgical procedure is presented. Further clinical studies are warranted to evaluate the radiographic and patient-reported outcomes of ITCL reconstruction.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}